Shooting Spree Zoloft 07/03/2005 Tennessee Troubled Man Treated by VA Pharmacist
 
 Summary:<br><br><!--StartFragment -->Paragraphs 12&nbsp;through 15&nbsp;read: &quot;Bianchi&#39;s notes from a July 3, 2002, session, for example, detail Gardner&#39;s mental health. He was worried, depressed and having difficulty sleeping.&quot;<br /><br />&quot;There were also &#39;&#39;<strong>feelings of guilt, a decrease in excitability and hostility (with) homicidal ideation (without) plan,&#39;&#39; </strong>according to Bianchi&#39;s progress notes.&quot;<br /><br />&quot;<strong>She ordered an increase in his prescription for Zoloft.&quot;<br /><br /></strong>&quot;&#39;Dr. Bianchi did not refer Patient 1 to a psychiatrist immediately as she should have done upon being <strong>notified of a patient&#39;s homicidal ideation,&#39;</strong> the letter states.&quot;<br /><br /><a href="http://www.tennessean.com/local/archives/05/01/66553227.shtml?Element_ID=66553227">http://www.tennessean.com/local/archives/05/01/66553227.shtml?Element_ID=66553227</a> <br /><br />VA pharmacist treated troubled man <br /><br />By ROB JOHNSON<br /><em>Staff Writer<br /><br /></em>The deputy U.S. marshals rolled the hulking Michael Gardner and his wheelchair out of a federal judge&#39;s hushed Nashville courtroom and straight toward an eight-year prison sentence for a terrifying shooting spree at the Alvin York VA Medical Center in Murfreesboro two years ago.<br /><br />While the criminal case against the former Veterans Affairs janitorial supervisor mostly ended at that moment last week, a federal tort claim against his old employer continues to rage because of new allegations that the man known as &#39;&#39;Big Mike&#39;&#39; had sought VA counseling in the months before his rampage and was treated with psychoactive drugs administered by a staff member who isn&#39;t a doctor.<br /><br />VA records show that Gardner was exhibiting &#39;&#39;homicidal ideations&#39;&#39; more than a year before he stalked the hallways of the hospital Oct. 7, 2003, firing birdshot at co-workers and police officers. He dropped his shotgun and surrendered before anyone was injured.&nbsp;&nbsp; <br /><br />His accumulating mental-health troubles, though, were well known to Vicki Bianchi, a clinical pharmacist at the center. Records show that she had been treating him with antidepressants, administering drugs without the oversight of VA psychiatrists.<br /><br />A close Gardner friend said she watched his physical and mental health decline precipitously in the months after an equal-opportunity dispute with the VA. So the veteran asked for counseling.<br /><br />&#39;&#39;There was a combination of things that were taking a toll on him,&#39;&#39; Gardner&#39;s close friend Donna Primm said last week. &#39;&#39;And I know that he thought he was getting qualified help from the woman who was counseling him.&#39;&#39;<br /><br />What caused her friend to walk into his workplace and start shooting, Primm does not really know.<br /><br />&#39;&#39;But I know this. Every man has his breaking point,&#39;&#39; Primm said. &#39;&#39;And at the VA, I think Mike went well past his.&#39;&#39;<br /><br /><strong>VA care questioned<br /><br /></strong>While she doesn&#39;t condone what he did that October day, she seriously questions whether Gardner got the right help ? and whether the care he got worsened his rapidly declining mental health.<br /><br />Meantime, VA officials have written Bianchi a letter informing her of their decision to remove her from the staff for a laundry list of alleged procedural violations, including practicing outside the scope of her duties.<br /><br />Bianchi did not return a message left with a woman answering the telephone at her Nashville home.<br /><br />Citing pending litigation, Alvin York officials would not comment about procedures at the Murfreesboro facility as they related to the Gardner case.<br /><br />Nor would VA public affairs officer Molly Reynolds answer questions about how a pharmacist would come to be handling the task of counseling a VA client.<br /><br />Ron Dooley, regional counsel for the VA, also declined to answer specific questions about the Gardner-Bianchi case, citing civil legal actions filed against the VA by Nashville attorneys David Raybin and David Randolph Smith on Gardner&#39;s behalf.<br /><br />A letter from the VA to Bianchi, though, spells out the administrative allegations against the pharmacist, who remains a licensed professional in Tennessee.<br /><br />The letter shows an ongoing counseling relationship between Gardner and Bianchi.<br /><br />Bianchi&#39;s notes from a July 3, 2002, session, for example, detail Gardner&#39;s mental health. He was worried, depressed and having difficulty sleeping.<br /><br />There were also &#39;&#39;feelings of guilt, a decrease in excitability and hostility (with) homicidal ideation (without) plan,&#39;&#39; according to Bianchi&#39;s progress notes.<br /><br />She ordered an increase in his prescription for Zoloft.<br /><br />&#39;&#39;Dr. Bianchi did not refer Patient 1 to a psychiatrist immediately as she should have done upon being notified of a patient&#39;s homicidal ideation,&#39;&#39; the letter states.<br /><br />The documents filed with the federal court show that again and again, Bianchi was tracking Gardner&#39;s mental health.<br /><br />She wrote recommendations about how the janitor&#39;s shift shouldn&#39;t be changed lest the added stress aggravate his state of mind.<br /><br />She wrote notes to excuse him from his work duties.<br /><br />On Feb. 12, 2003, she entered another progress note, the VA document states:<br /><br />&#39;&#39;&#39;He is willing to try a sleeping aid at this time because the chronic lack of sleep is causing mood changes and regression of his symptoms. Will add trazadone.&#39;<br /><br />&#39;&#39;Trazodone is an antidepressant used in treating major depression. There was no countersignature by the managing physician,&#39;&#39; the VA document states.<br /><br />In June, she diagnosed Gardner with post-traumatic stress disorder, citing events from his military service in Korea.<br /><br />The VA document notes that Bianchi &#39;&#39;has no authority or training to diagnose such a medical and psychiatric condition. There was no countersignature by the managing physician.&#39;&#39;<br /><br /><strong>Breaking point<br /><br /></strong>After a series of employment-related disputes at the VA, Gardner arrived one day with his shotgun.<br /><br />He strolled into an office, restrained one woman and pointed a shotgun at another man, according to assistant U.S. Attorney Trey Hester.<br /><br />Gardner fired the gun at the desk where the man had been sitting and behind which he&#39;d taken cover.<br /><br />He left that office and fired through the closed door of an empty office.<br /><br />He went outside and fired a blast into the windshield of a responding VA police cruiser. He surrendered when the officers returned fire, Hester said.<br /><br />Gardner told the officers he had only intended to scare people.<br /><br />He eventually pleaded guilty to assaulting federal employees with a shotgun and agreed to the eight-year prison sentence, a deal which U.S. District Judge Aleta Trauger affirmed last week.<br /><br />Some of his victims sat on one side of the courtroom at the sentencing hearing. They declined afterward to talk about the case with a reporter.<br /><br />At the same time, Gardner smiled and waved to relatives and friends who had arrived to lend him their support.<br /><br />&#39;&#39;I love you all,&#39;&#39; he said.<br /><br />&#39;&#39;We love you, too,&#39;&#39; they answered.<br /><br />Then the marshals took the 53-year-old man away. He probably will be assigned to a prison medical facility because of his diabetes, heart troubles and breathing difficulties, which force him to use a wheelchair.<br /><br />His friend Primm knows he faces a difficult eight years behind bars.<br /><br />&#39;&#39;When Mike would go dove hunting with my husband and my boys, he would go to one corner of the field with one of my sons,&#39;&#39; Primm said. &#39;&#39;I trust him that much. And if he were somehow able to go hunting again with them tomorrow, I&#39;d still trust him with my sons.&#39;&#39;<br /><br /><em>Rob Johnson can be reached at 664-2162 or at <br /></em> 
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